Suicidal ideation and attempts among adults in eastern Ethiopia: A community-based cross-sectional study

Suicide is a significant global mental health issue and a leading cause of death, with over half a million lives lost annually. The majority of suicide deaths occur in low- and middle-income countries (LMICs), yet there are limited data on suicidal behavior in these regions, particularly in Ethiopia. Given the rising trends of mental health issues worldwide and the alarming rate of suicide in LMICs, this research addresses a critical gap in knowledge regarding suicidal behavior in Eastern Ethiopia, which is essential to inform local public health strategies. Therefore, the study aimed to assess the prevalence and associated factors of suicidal ideation and attempts among adults in the Kersa, Haramaya and Harar Health and Demographic Surveillance System in Eastern Ethiopia in 2022. A community-based cross-sectional study was conducted among 1,411 participants selected using a multistage sampling technique. Binary logistic regression was employed to identify factors associated with suicidal ideation and attempts. The findings revealed that 9.8% and 6.2% of participants reported suicidal ideation and attempts, respectively. A history of mental illness [adjusted odds ratio (AOR) = 6.82, 95% confidence interval (CI): 4.63-10.05] and khat use (AOR = 2.34, 95% CI: 1.48-3.69) were factors significantly associated with suicidal ideation. Similarly, rural residence (AOR = 4.32, 95% CI: 2.17-7.58), a history of mental illness (AOR = 6.02, 95% CI: 3.78-9.60) and khat use (AOR = 2.23, 95% CI: 1.29-3.85) were strongly associated with suicide attempts (p < 0.05). The study highlights that nearly one in 10 individuals in the community experienced suicidal ideation or attempts, underscoring the urgent need for attention to these mental health concerns. In conclusion, suicidal ideation and attempts are prevalent in Eastern Ethiopia and are significantly associated with mental illness, khat use and rural residence. Early screening, detection and management of suicidal behavior at the community level are recommended to address this pressing public health issue.